Council for Affordable Quality Healthcare (CAQH)

Universal Provider Datasource

CAQH is a non-profit alliance of health plans, networks and industry trade associations that develops and implements collaborative, public-private initiatives to simplify and streamline healthcare administration.

Universal Provider Datasource® (UPD) was developed by CAQH to streamline the credentialing application requirements of healthcare organizations. UPD is used by more than 640,000 physicians and other healthcare professionals to post the credentialing and demographic data elements required by health plans, hospitals and other healthcare organizations to a secure, national database; posting occurs once and then updates are made as needed.

Previously, each provider practice spent countless hours and thousands of dollars annually to complete multiple credentialing applications. Given the results of UPD, many prominent provider and quality organizations such as the AMA, ACP, AAFP, NCQA, and URAC have been active in promoting the adoption of UPD. Additionally, certain states are looking at other opportunities to improve the quality of their provider data, such as emergency responder information, and are considering how the critical mass of providers participating in UPD could assist those efforts.

Results

• CAQH estimates that UPD is reducing provider administrative costs by nearly $100 million per year and has eliminated more than 2.5 million legacy paper applications to date.
• Given the results of UPD, many prominent provider and quality organizations such as the AMA, ACP, AAFP, NCQA, and URAC have been active in promoting the adoption of UPD.
• Additionally, certain states are looking at other opportunities to improve the quality of their provider data, such as emergency responder information, and are considering how the critical mass of providers participating in UPD could assist those efforts.

***Submitted by Gwendolyn Lohse, CORE Director, CAQH, Lohse, glohse@caqh.org

Published: January 26, 2009